Eating Behavior and Obesity: Behavioral Economics Strategies for Health Professionals

257 Pages·2011·2.109 MB·English

by  Dr. Shahram Heshmat PhD

Eating Behavior and Obesity
Behavioral Economics Strategies
for Health Professionals
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Shahram Heshmat, PhD , is an Associate Professor of Public Health and
Economics at the University of Illinois at Springfi eld and an Adjunct Associate
Professor of Medical Humanities at Southern Illinois University. His research
is aimed at understanding the role of emotions in consumer behavior and
well-being, applications of the principles of behavioral economics to appetitive
behavior, changing health behavior, and designing prevention policies.
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Eating Behavior and Obesity
Behavioral Economics Strategies
for Health Professionals
Shahram Heshmat, PhD
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ISBN: 978-0-8261-0621-6
E-book ISBN: 978-0-8261-0622-3
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Library of Congress Cataloging-in-Publication Data
Heshmat, Shahram.
Eating behavior and obesity / Shahram Heshmat.
p. cm.
Includes bibliographical references.
ISBN 978-0-8261-0621-6 — ISBN 978-0-8261-0622-3 (E-book)
1. Eating disorders. 2. Decision making—Psychological aspects. I. Title
[DNLM: 1. Eating Disorders. 2. Feeding Behavior—psychology. 3. Decision Making. 4. Obesity.
5. Socioeconomic Factors. WM 175]
RC685.A65H47 2011
616.85’26—dc23 2011017984
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Contents
Preface vi i
Acknowledgments xii i
1. Behavioral Economics and Eating Decisions 1
2. Explaining Eating Behavior 11
3. Some Basic Economic Concepts 33
4. An Economic Perspective on Eating Behavior 55
5. Socioeconomic Disparities in Health and Obesity 77
6. Decision Making Over Time 97
7. How We Make Decisions: The Role of Emotion 117
8. Food Addiction and Obesity 135
9. Overeating and Decision-Making Defi cits 151
10. Why Dieters Relapse 171
11. Self-Control Strategies 185
12. Policy Implications and Conclusion 207
References 213
Index 235
v
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Preface
T his book utilizes b ehavioral economics as the overarching conceptual
framework to discuss the root causes of obesity. This relatively new
fi eld blends insights from psychology and economics. Behavioral eco-
nomics is a generalization of r ational choice theory, which incorporates
concepts of rationality, willpower, and self-interest in a systemic way. Its
basic premise is that humans are hardwired to make judgment e rrors and
they need a “nudge” to make decisions that are in their own best interest.
The fi eld of behavioral economics is mostly unknown to practitioners in
public health, yet it can offer a valuable framework for understanding
health behavior for public health professionals. Principles of behavio-
ral economics can capture the complexity of individual judgments and
health behaviors; this makes it a useful foundation for improving health
promotion policy.
B ehavioral economics provides a framework to understand when
and how people make errors. Basic tenets of behavioral economics dem-
onstrate that the environment plays an important role in eating and body
weight regulation. This introductory text integrates the basic concepts of
behavioral economics and public health to increase our understanding of
individual eating behaviors that can then be integrated into the formula-
tion of preventive strategies.
The traditional economic perspective relies on a “market” approach,
in which individuals are assumed to be making autonomous decisions
based on their own preferences with a goal of maximizing individual sat-
isfaction. However, many of these assumptions are i naccurate and simply
do not fi t what we know about individual behavior from p ublic health.
Human beings have limited cognitive abilities and limited willpower.
Conscious and unconscious factors infl uence people’s decisions in ways
that cause us to act against our own best interest. As will be discussed
throughout this text, biases, gut feelings, and habits often compete with
deliberate consideration of information. While individuals may be aware
vii
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viii Preface
of the factors that contribute to obesity, their everyday lifestyle choices
do not refl ect this knowledge. Rather, these choices are often made in
an unconscious and more impulsive manner. Because of this, individu-
als frequently make decisions that depart systematically from the pre-
dictions of economists’ standard rational model. Behavioral economics
attempts to understand these departures and, more generally, integrate
psychologists’ understanding of human behavior into economic analysis.
Identifying ways in which behavior systematically deviates from opti-
mality can then generate new insights into the underlying choice mecha-
nism. Understanding why, how, and when people choose certain foods
and consume them in certain amounts is a useful approach to preventing
or simply changing potentially unhealthy eating behavior that contrib-
utes to obesity. Based on the fi ndings and methods of behavioral eco-
nomics, the book presents intervention strategies to help individuals to
improve their eating behavior and enhance their well-being. Armed with
the information presented in this text, it is hoped that readers understand
the psychology behind excessive eating and learn how to promote a long-
term healthy lifestyle.
OBJECTIVE
T he purpose of this book is to present a behavioral economics perspective
on food choice. An understanding of the factors that infl uence food choice
helps reveal some of the diffi culties, as well as solutions, in d irecting in-
dividuals toward healthier eating behavior. From a behavioral econom-
ics perspective, public policy attempts to foster healthy eating behaviors
that focus on understanding and changing the way individuals make
food decisions.
B ehavioral economics identifi es a large number of circumstances in
which people seem to behave inconsistently and in which their decisions
deviate from what is predicted by the rational principles of the standard
economic model. Identifying these conditions provides an understand-
ing of, for example, what factors make it harder for dieters to resist attrac-
tive food, and will help dieters to resist temptation. Knowing why people
fail to maintain a desired healthy behavior over time will go some ways
toward avoiding relapse, and to move people in a direction that will
make their lives better.
It is hoped that this book will enhance the understanding of
decision-making processes that underlie maintaining a desired healthy
behavior over the long term. This is accomplished by looking at conditions
in which the decision making is impaired or even breaks down. The knowl-
edge of these biases should help dieters to develop problem-solving skills
in weight management. A recent review of studies on the effectiveness of
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Preface ix
weight-maintenance strategies concludes that programs that incorporate
continued skills in problem-solving and coping with challenges, and tech-
niques for sustaining behavior change, lower the rate of relapse (Institute of
Medicine [IOM], 2004). The increased knowledge of behavioral economics
could promote effective weight-loss management and obesity prevention,
and improve population-based health benefi ts (IOM, 2004).
HOW THIS BOOK IS ORGANIZED
T he book is organized into 12 chapters. The chapters are structured
around a series of basic concepts about individual eating behavior.
C hapter 1, “Behavioral Economics and Eating Decisions,” explains
basic concepts in behavioral economics and how they might be a pplied
to eating behaviors.
C hapter 2, “Explaining Eating Behavior,” briefl y discusses trends in
obesity and its consequences on population health. Overeating is one of the
most pressing health issues affecting developed countries. The main goal
in this chapter is to understand why we overeat. The chapter describes the
biological and behavioral factors that infl uence eating behavior and the
processes by which they infl uence body weight. Changes in these factors
might be responsible for increased food intakes and obesity.
C hapter 3, “Some Basic Economic Concepts,” describes basic eco-
nomic concepts and tools as they apply to resource allocation decisions.
The main objective is to enhance readers’ understanding of economic
behavior.
Chapter 4, “An Economic Perspective on Eating Behavior,” explains
the link between the rising obesity rates and the economics of food choice.
The chapter describes the relevance of fast food, food marketing, and
social effects on how we make choices about what we eat. It also offers
implications for interventions.
Chapter 5, “Socioeconomic Disparities in Health and Obesity,” focuses
on the broader individual as well as social determinants of overweight
and obesity. This perspective attempts to understand and explain obes-
ity at the population level by going beyond the individual characteristics
(e.g., diet and physical activity levels). In this chapter, socioeconomic sta-
tus, disparities, poverty, social norms, and other factors are considered as
they impact eating habits and obesity.
C hapter 6, “Decision Making Over Time,” uses economic principles to
explain how delayed rewards are discounted by individuals, and the ways
in which people undervalue the future consequences of their actions. The
impact of these principles upon our eating decisions will be discussed.
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